Last year’s massive Ebola crisis, which originated in West Africa, provoked major concerns over global capacity to address wide-ranging medical emergencies. At a global health panel conducted at the Blouin Creative Leadership Summit on Monday in New York City, leading health experts convened to discuss the world’s needs in terms of addressing infectious outbreaks and handling health emergencies.
Much of the problem comes down to basic human resource capacity. Dr. David Bangsberg, director of the Center for Global Health, Massachusetts General Hospital, said that developing human resource capacity for healthcare systems is vital, and that those systems need to attract and retain workers. In 2030, the world will be short 12.9 million healthcare workers — a problem made tragically evident by the Ebola crisis, noted Bangsberg. He added that in Liberia six Ebola victims out of 1,000 died, but that eight healthcare workers per 1,000 died. “We lost ground,” he said. All the progress that Liberia had made in terms of maternal/infant death rates had been lost.
The lack of infrastructure plays into this problem. Dr. Mary Jo Boufford, president of the New York Academy of Medicine, said that despite the existence of a concrete, effective emergency strategy, there is a global need to follow through with international donor agreements that are not being met. Unfortunately, that feat also requires efforts to strengthen traditionally weak governments and ministries of health.
That donor problem is one that needs to be addressed on many levels, one of which is the relationship between donor state and receiving state. Many existing provisions do not address health crises effectively. Boufford noted that some African heads of state have lamented the misallocation of funds. In states with dwindling HIV rates, oftentimes international funding allocated specifically for HIV recovery is unneeded; furthermore, receiving states are not allowed to use the money for other health-related purposes. Funding distribution needs a restructured approach.
The cycle of poverty and disease obviously plays a role here, but Dr. Christine Sow, executive director of the Global Health Council, pointed out that Ebola isn’t necessarily an “ailment of poverty,” although the impact of the disease is definitely related to poverty. And the element of community is essential in terms of international participation.
Sow said that the response to the international health crisis of Ebola was nearly militant, but local response was a mess. NGOs and faith-based organizations took on the community reach aspect. Needs like translating information into local languages fell by the wayside. As a result, local inhabitants became suspicious of outside help; the disease spread because people didn’t respect what was being told to them. Finally, governments realized that they needed to work with communities in order to effectively spread medical reach. She said, ultimately “we need to work with local stakeholders from the beginning in order to have solid, appropriate responses.”
Clearly, Ebola highlighted many holes in the global framework for responding to health-based emergencies. The hope is that the international health community does not forget the lessons.